•Blilateral iliac crest bone marrow aspirate and biopsy is used to confirm the diagnosis and to determine the extent of the tumor. Staging of neuroblastoma is done according to the International Neuroblastoma Staging System (INSS) and requires the combined results of a tissue biopsy, bone biopsy, abdominal CT scan, bone scan, and chest radiography.
•Neuroblastomas are tumors that arise from cells of the sympathetic nervous systems. Cells are highly undifferentiated and invasive, occurring most frequently in the abdomen near the adrenal gland or spinal ganglia.
•Symptoms include abdominal mass, abdominal pain, weight loss, anorexia, proptosis, and periorbital ecchymoses.
•If an adrenal tumor is present, it will stimulate production of cathecholamines. A urine sample will be tested for the presence of catecholamines.
•A head CT is only indicated if brain involvement is suspected.
•Lumbar puncture is not used for the diagnosis or staging of neuroblastoma.